EFTA01580229.pdf

Funds Transfer Request (Please Typa ImtilietiOM) J.P.Morgan i VN ?-•:rFfef :4?:* .rti ttaili 0t 171 40 3 14Frat 2F5704 1. cygge Effective Date: 06/0O3 Please enter CUIleff Of Uwe dale only Select Approptate Payment Type and Fields will be Displayed 0 JPMC Transfer 0 ACM 0 Check 0 Domestic Wire International Wire Principal: $250,000.00 Income: nraiciWge. er r Wert Ait4oriaia45O Debit Account I: Debit Account Title: 'in - ' • :t3• 91c eii; - • . Address 1: Receiving Bank ABA: Receiving Bank Name: [IP Morgan Chase Address 2: Beneficiary Account Beneficiary Name: lDarren K Indyke PLLC 1 City: la” lb(3W.:7).0:2)141 .1; r1 Parry Of. State: Zip Code: 1 Account Type: LJ DOA (US) Swift 0 Other Intormidiary Bank Account/Code: Intermediary Bank Name: ... . Liesitatics - ,..;;.viry;,...,,::',.. .:;::;\<<-',...;•\• Payment Details (Reference/ Advice Description/Addenda) [00/03/13 Authorized By Date ID: 036306067532419DATE: 06!061201317:24:00Page 2 of 2 DID: 8887316607CSID: INDEX1: INDEX2: Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059519 EFTA01580229